SONIC FACTS FOR SOUND ARGUMENTS: MEDICINE, EXPERIMENTAL PHYSIOLOGY, AND THE AUDITORY CONSTRUCTION OF KNOWLEDGE IN THE 19TH CENTURY

Abstract

This article addresses the auditory culture of science and problematizes sonic practices as epistemological practices. In order to deepen our understanding about how scientific knowledge is acquired, represented, and constructed through sound, I discuss case studies from the history of medicine and the life sciences in which sound and listening do not form the objects of scientific observation and reasoning but epistemic tools employed by scientists to produce “sound” scientific facts. First I reassess the question why physicians began to listen to the sounds of the human body in order to diagnose diseases around 1800. After that, I follow late nineteenth-century neurophysiologists who used the electric telephone to study the nervous system by transforming bioelectric currents into sounds. I argue that such acoustemic practices and technologies favorably emerge in the presence of in-visibilities, i.e. situations in which a direct visual observation or representation of the object of study is hindered or impossible. I also show that the success of these practices largely depends on whether or not it is possible to develop the sounds of science into stable frameworks of sonic facts.

Introduction

As Canadian sound student Jonathan Sterne has recently pointed out, sound studies may be regarded as “a name for the interdisciplinary ferment in the human sciences that takes sound as its analytical point of departure or arrival. By analyzing both sonic practices and the discourses and institutions that describe them, it redescribes what sound does in the human world, and what humans do in the sonic world” (Sterne 2012: 2). In doing so, sound students “problematize sound and the phenomena around it, including their own intellectual traditions” (Sterne 2012: 4). Consequently, sonic epistemologies may address methodological questions within the field of sound studies, but they may also refer to enterprises that problematize sonic practices as epistemological practices. In this article, I follow the latter approach in order to explore the auditory culture of science.

The Auditory Culture of Science

During the past three decades, historians of science, technology, and culture repeatedly emphasized the fundmental role of visual practices for producing and circulating scientific knowledge. Numerous works from the fields of science studies, history of science, visual studies, and art history treat, for instance, the epistemological status of vision (Crary 1990), scientific images and visualization (Galison 1997; Daston and Galison 2007), or inscription technologies (Rheinberger 1997; Lenoir 1998). Bruno Latour has even generalized scientific practice as a process of “thinking with eyes and hands” (Latour 1990: 19).

Along with a growing interest in sound studies in the early 2000s, scholars from science and technology studies have also pointed to the existence of an auditory culture of science. Cyrus Mody, for example, traces the “sounds of science” in the laboratories of surface scientists and argues that “sound is an integral (if often overlooked) ingredient in tacit knowledge” (Mody 2005: 177). In their recently published Oxford Handbook of Sound Studies, Trevor Pinch and Karin Bijsterveld group articles around a number of different places where sounds are produced, perceived, captured, and transferred in science, technology, and medicine (Pinch and Bijsterveld 2012). In the 2013 issue of the well-known history of science journal Osiris entitled Music, Sound, and the Laboratory from 1750-1980, Alexandra Hui, Julia Kursell, and Myles W. Jackson present essays which examine the historical reciprocity between music and science (Hui, Kursell and Jackson 2013).

Following these studies, this article aims to contribute to our understanding about how scientific knowledge is acquired, represented, and constructed through sound. I deliberately chose to study epistemic practices in the sciences—as opposed to, for instance, everyday life or the arts—because one of the central aspects of scientific culture is the justification of knowledge as being “objective”, i.e. scientifically valid and convincing. This point is particularly interesting from a sound studies point of view. Jonathan Sterne reminds us that “seeing and hearing are still often associated with a set of presumed and somewhat clichéd attributes” which he calls the audiovisual litany. Since, according to the litany, “hearing tends toward subjectivity, vision tends toward objectivity” (Sterne 2012: 9), the question arises whether there are also sonic practices that are used to generate scientific knowledge in the sciences. Or, as Cyrus Mody puts it, “do sounds merely surround knowledge making in labs, or are they also bound up in the knowledge that gets made?” (Mody 2005: 185–186).

In order to be able to study sonic epistemologies in the sciences, I am less interested in sound and listening as objects of scientific observation and reasoning but as epistemic means or tools used by scientists to produce and work with scientific facts and arguments they consider to be “objective” or “sound” (in the adjectival use of the word). To emphasize this point, I suggest calling sonic methods that are being deployed as epistemic tools acoustemic practices/technologies, a term that draws on Steven Feld’s concept of “acoustemology” (Feld 1996: 91–135). For Feld, acoustemology refers to a methodology of field work in which the ethnographer primarily focuses on sound as a form of knowing in the experience of a specific culture. I am transferring this approach in order to study the auditory culture of science. However, instead of taking into account the soundscape of science as a whole, as Mody does, for example (Mody 2005), I am restricting myself to the study of acoustemic practices/technologies. In so doing, I try to assess the following set of research questions: How do acoustemic practices work, how is knowledge being constructed sonically? If the production of scientific facts is usually associated with visual display technologies, which circumstances make the conception and application of auditory practices a desirable option for scientists, and which enable or hinder their emergence and dissemination? How do acoustemic practices relate to visual practices, and under what conditions are they regarded as epistemologically “objective”?

Trained Ears and Auditory Displays

As a pertinent field of study, current research on sonification and auditory display may quickly come to mind. Yet sonification research is still in its infancy, and therefore we currently do not know whether—and if so, to which extent—sonification practices will be able to present serious alternatives of scientific representation (Supper 2012a; Sterne and Akiyama 2012). Although sonification methods and acoustic displays are being tested selectively in various scientific areas (Hermann, Hunt and Neuhoff 2011; Vickers 2012), the sonification community is still searching for the ultimate “killer application” (Supper 2012a; Supper 2012b). Therefore, I chose to study historical cases in which the auditory production of knowledge was practiced in the sciences. A brief look into the history of science reveals numerous cases in which listening techniques and acoustic technologies have been deployed as epistemic tools in scientific research processes, especially in nineteenth-century life sciences. In the first section, I will reassess the question why physicians began to listen to the sounds of the human body in order to diagnose diseases around 1800. In the second part, I will follow late nineteenth-century physiologists who used the electric telephone as a laboratory device to render audible bioelectrical currents in the muscles and nerves of dissected animals. Examining these case studies, I will argue that acoustemic practices/technologies—and hence, the auditory construction of knowledge—comprise, to varying degrees, practices of a trained ear and technologies of auditory display.

Diagnostic Listening in Medicine

In the following section, I will recall diagnostic listening practices developed in medicine around 1800, the first being percussion, which is tapping the patient’s chest in order to assess the physical condition of the underlying tissues and organs. The second technique is mediate auscultation, which is listening to the patient’s body by means of a stethoscope. Although in these examples no data is actually converted or transduced into sound as, for instance, in sonification, diagnostic listening techniques nevertheless offer useful insights into how scientific knowledge is actually constructed sonically. In this section I draw extensively on existing work from the history of science, science and technology studies, and sound studies, but I hope to be able to add some original thoughts as well.

Sounding Bodies: The Percussion of the Chest as a Diagnostic Tool

The use of listening techniques in medical examination is common contemporary practice. The history of these methods dates back well into the eighteenth century, when the Viennese physician Joseph Leopold Auenbrugger (1722–1809) presented the so-called “percussion of the chest” as a diagnostic method. In his 1761 treatise A New Discovery that Enables the Physician from the Percussion of the Human Thorax to Detect the Diseases Hidden Within the Chest (Auenbrugger 1761), Auenbrugger argued that percussion sounds may convey useful information about the physical condition of a patient and hence could serve as a diagnostic tool. In the introduction of his book he states:

I here present the Reader with a new sign I have discovered for detecting diseases of the chest. This consists in the Percussion of the human thorax, whereby, according to the character of the particular sounds thence elicited, an opinion is formed of the internal state of that cavity. (quoted after Forbes 1936: 7)

Auenbrugger began working as a physician at the Spanish Military Hospital in Vienna in 1751 where, over the course of seven years, he developed his diagnostic techniques. He refined his observations in his daily routine and also by experimenting with cadavers. In order to study the deviations of abnormal sounds from the normal tone, for instance, he injected liquid into dead bodies and concluded that “it will be found that the sound elicited by percussion, will be obscure over the portion of the cavity occupied by the injected liquid” (Forbes 1936: 13). According to legend, Auenbrugger had appropriated this technique from his father, who assessed the amount of wine left in barrels by tapping on them. In fact, however, Auenbrugger’s Dutch teacher van Swieten was already practicing the percussion of the abdomen.

Figure 1: Joseph Leopold Auenbrugger (1722–1809).

In his treatise Auenbrugger discerns the normal, “sonorous” sound, the “sonus altior”, the “sonus obscurior” and the “sonus prope suffocatus” or “sonus percussae carnis”. These distinctions are still in use today and are called resonant, hyper-resonant, stony dull, or dull percussion sounds. According to Auenbrugger, “unnatural sounds” are caused by physical alterations of the body, e.g. a pathological increase or decrease of air or liquids in the body or an expansion or hardening of organs (Forbes 1936: 11–12). Thus, Auenbrugger regarded abnormal sounds to be diagnostic signs for determining various diseases of the chest. Historians of medicine therefore consider Auenbrugger to have “initiated modern scientific medicine” (Clendening 1960: 306). The reason for this was primarily due to the fact that Auenbrugger had achieved the construction of a fixed vocabulary of distinct types of sounds that were tied to physical changes within the body through a referential or indexical relationship and that he explained the nature of the sounds as related to exclusively physical causes [or: sources]:

The principles of the Inventum Novum are two: first, that the sounds produced by percussion must be regarded simply as acoustic phænomena, and named accordingly; secondly, the sounds are to be explained by reference to corresponding physical states, that is to say, to the presence or absence of air in the part percussed. (Gee 1883: 60)

As convincing as Auenbrugger’s approach may seem today, percussion did not gain immediate recognition among his own contemporaries. It was generally ignored for almost half a century (Lesky 1966: 140). Only after the renowned French anatomist and personal physician of Napoléon Bonaparte, Jean-Nicholas Corvisart (1755–1821), published a French translation of Auenbrugger’s treatise in 1808 did percussion become recognized and practiced among physicians (Corvisart 1808; see also Otis 1898: 7).

How can we explain this delay, and what can we learn from it? The main problem with Auenbrugger’s method was not its auditory means of knowledge production as such, but that it was basically incompatible with the dominant paradigm of medical diagnosis in the eighteenth century (Ackerknecht 1967; Foucault 2012). Up until Auenbrugger’s lifetime, disease patterns were analyzed based on symptoms of sickness, such as fever, blotchy skin, discharge, as well as on the subjective symptoms articulated by the patient, such as nausea or dizziness. Doctors recorded these symptoms through observation and questioning and determined the disease on the basis of so-called nosologies, i.e. extensive theoretical classification systems, in which diseases were organized very much like plants were in botanical classification systems. Historian of medicine Jacalyn Duffin writes:

A ‘disease’, then, was an idea assembled from a constellation of subjective symptoms that depended on their type, sequence, severity, and rhythm. Nosologists (or those who studied diseases) sorted diseases into Classes, Orders, Genera, and Species; some systems included more than two thousand types of diseases as did that of the Montpellier professor François Boissier de Sauvages (1706–1767). (Duffin 1998: 27)

After the French Revolution medical knowledge changed profoundly. The old classification systems came under heavy criticism and were successively replaced in the first half of the nineteenth century by the emerging discourse of pathological anatomy, which was based on the new idea that a disease should be defined by lesions (i.e. physical alterations of the body) rather than by symptoms of sickness. Therefore, the theory relied heavily on autopsy findings. While the old nosologies were comprised of complex taxonomies of all kinds of symptoms, pathological anatomy was concerned with empirical studies of physical conditions within the body. Against this background, it becomes apparent why Auenbrugger’s contemporaries met the technique of percussion of the chest with indifference and skepticism: An eighteenth-century physician would not have valued a diagnostic method that suggested actively producing artificial signs by percussing the patient’s body, because these signs were, of course, not present in the nosologies and hence would not—in their view—contribute to the determination of the disease. Foucault notes in his book Birth of the Clinic:

It was natural that clinical medicine at the end of the eighteenth century should ignore a technique that made a sign appear artificially where there had been no symptom, and solicited a response when the disease itself did not speak: a clinic as expectant in its reading as in its therapeutics. But as soon as pathological anatomy compels the clinic to question the body in its organic density, and to bring to the surface what was given only in deep layers, the idea of a technical artifice capable of surprising a lesion becomes once again a scientifically based idea. [...] Sounding by percussion is not justified if the disease is composed only of a web of symptoms; it becomes necessary if the patient is hardly more than an injected corpse, a half filled barrel. (Foucault 2012: 199–200)

In conclusion, the auditory form of Auenbrugger’s approach was not the problematic issue, but rather that he focused on the physical conditions of the disease within the body while his contemporaries were collecting observable symptoms of sickness as well as the subjective symptoms of the patient. Therefore Auenbrugger was indeed well ahead of his time.

While pathological anatomy boomed in post-revolutionary medical science, it also bore an obvious disadvantage for medical practice, since autopsy, its preferred epistemic practice, could only be performed on the dead. Therefore clinicians such as Corvisart sought an alternative method for investigating the human body. As a result of this transition in medical epistemology, the dialogue between doctor and patient, which formerly had been the basis for medical diagnosis, was gradually replaced by the physical examination of the body (Sterne 2003: 118–119). When Auenbrugger published his treatise on percussion, the old system of medical knowledge was still strong. Corvisart, on the other hand, was recognized as a leading figure of the new empirical turn in medicine. Corvisart emphatically promoted what he termed an éducation médical des senses, i.e. the refinement of the clinician’s senses in order to locate and identify the site of disease within the body (Corvisart 1808). Based on this concept, Corvisart strongly propagated physical examination practices such as palpation, percussion, and direct auscultation, which is listening to the body by placing one’s ear on the patient's thorax (Duffin 1998: 33).

After 1800, the body became the site and the source of an alternative discourse on disease, governed by the rules of pathological anatomy. Corvisart and his followers explicitly welcomed the percussion of the chest as an objective method of investigation, since it was not based on ambivalent signs of sickness and subjective symptoms articulated by the patient but on physical alterations of the body. While percussion was hardly in line with the old semiotic paradigm of medicine, it was highly regarded by the pioneers of the new medical science.

Mediate Auscultation: Mapping the Soundscape of the Disease

Inspired by his teacher Corvisart, the young physician René Théophile Hyacinthe Laënnec (1781–1826) began to study the inner soundscape of the human body for diagnostic purposes. In order to “listen-in” into the body, Laënnec invented a tube-shaped listening device in 1816, which he termed the stéthoscope. Since the Greek word stéthoscope literally means “chest-explorer” or “chest-observer”, one could say the instrument offered an auditory “glimpse” into the human body—a listening practice Laënnec referred to as “mediate auscultation” (auscultation médiate).

Figure 2: “Laennec examines a consumptive patient with a stethoscope in front of his students at the Necker Hospital.” Painting by Théobald Chartran.

But how exactly does listening contribute to the diagnosis of diseases? Earlier in 1816, Laënnec had been appointed chief physician to the Hôpital Necker, a small Paris hospital that specialized in diseases of the chest. This hospital position was in fact crucial to the development of mediate auscultation. After 1800, the clinic increasingly turned into a laboratory space for medical research. At the Necker hospital, Laënnec started to auscultate all his patients (his ward consisted of about one hundred beds) on a daily basis and successively explored the soundscape of the human body. Eventually Laënnec was able to develop a vocabulary of normal, abnormal, and pathological sounds. Among respiratory sounds, for instance, he distinguished between acoustic phenomena such as pectoriloquie (which referred to an increase of resonance or volume, caused by tubercles or other pathological cavities in the lungs), bronchophonie (which indicated e.g. widened bronchia), and aegophonie or “goat-voice” (due to a bleating quality of the sound) (Laënnec 1838: 43–51).

Figure 3: René Théophile Hyacinthe Laënnec (1781–1826).

The relationships between respiratory sounds and physical lesions of the body were by no means self-evident: Laënnec had established the diagnostic signs in a painstaking process of carefully matching auscultation observations and autopsy findings (see also Sterne 2003: 121–124):

In order to classify which of the bodily sounds were due to physical changes caused by a disease, … he linked to physical alterations of the body found by dissection, e. g. tubercles in the lungs and other kinds of lesions. Due to these constant comparisons Laënnec was able to transform sounds evoked by distinct lesions into positive facts or as he put it, ‘pathognomonic signs’. (Duffin 1998: 138).

It should be clear that listening alone would not have allowed Laënnec to determine the actual causes of the sounds. He was able to obtain and validate his acoustemic deductions only by consistently performing autopsies on as many patients as possible. To discern ambivalences between the sounds, for instance, Laënnec added probable physical causes, preferred sites of occurrence, and other physical information to the descriptions of each type of sound. In order to be classified as a “pathognomonic sign” for a specific type of lesion, sounds had to meet a set of carefully evaluated conditions:

Laënnec insisted, a sign must be specific, certain, and rigidly infallible in all cases. ‘Specificity’ means that a sign is peculiar to one condition only. If a sign is not specific, then it can occur in conditions other than the one for which it is intended to be an indicator, resulting in a false positive. Specificity was not Laënnec’s word for this priority; he preferred the words ‘pathognomonique’ and ‘constans’. Nevertheless, this concept of specificity held absolute control over his formulation of auscultatory semiology. He abhorred the false positive. Laënnec also insisted on a certain level of sensitivity in his signs. If a sign is ‘sensitive’, then it will appear in every example of a condition regardless of how minimal the change may be. If a sign is not sensitive, there may be cases which escape detection: false negatives. Sensitivity is independent of specificity. For example a sign may be very sensitive to a certain condition and also non-specific, resulting in many false positives, but no false negatives. (Duffin 1998: 69)

In following this method, Laënnec especially favored sounds which he considered to be unique indicators of certain lesions: “Laénnec therefore laid down ‘pectoriloquy’ as the only certain pathognomonic sign of pulmonary phthisis, and ‘egophony’ as the sign of pleuretic discharge” (Foucault 2012: 196–197). Consequently, Laënnec rejected most of the symptoms which previously had been used to determine lung diseases, especially coughing, shortness of breath and sputum: “Laennec declared them totally unreliable symptoms by which to discriminate illness. They could differ in character in the same disease, and were often similar in different diseases” (Reiser 1978: 26).

After approximately two years of research, Laënnec published his results along with extensive descriptions of cases and disease patterns in his 1819 treatise De l’auscultation médiate ou traité du diagnostic des maladies des poumons et du cœur (Laënnec 1819). Shortly thereafter, bodily sounds were widely discussed in French medical science and Laënnec’s treatise was soon to be translated into several languages. During the course of the nineteenth century, more and more physicians learned to sharpen their ears. In fact, mediate auscultation became an extremely successful medical practice, since—for the first time—practicing physicians were able to diagnose diseases on the basis of the new science of pathological anatomy. By replacing autopsies as the primary diagnostic means, mediate auscultation became, as Jonathan Sterne writes, “the technique whereby the dead body of pathological anatomy first came back to life” (Sterne 2003: 128).

Another reason for the general dissemination of mediate auscultation was the fact that Laënnec and his contemporaries considered mediate auscultation to be an objective method of medical diagnosis, since it excluded ambivalent as well as subjective symptoms of sickness and relied, like Auenbrugger’s percussion, solely on physical signs that corresponded to specific lesions. As a result, the sounds did not only refer to existing diseases. Since Laënnec often regarded the sounds of the body as the only valid ‘pathognomonic signs’, he reorganized many disease patterns by basing them entirely on sonic facts. The auditory construction of medical knowledge heavily depended on the strong ties between pathological anatomy and mediate auscultation. This way, practices of trained ears became a dominant form of medical diagnosis for almost a century. Even in 1900, shortly before the auditory methods were superseded by the visual technology of X-ray photography, sonic practices and classification systems were praised by physicians as one of the greatest achievements of modern medicine (Otis 1898). By 1930, disease patterns were gradually redefined on the basis of roentgenographic “shadows”, ultimately leading to a decline of diagnostic listening (Pasveer 1992). But despite the ubiquity of imaging technologies in today’s medicine, the stethoscope is still considered to be the symbol of the modern physician.

Video 1: Scrubs Opening Titles (note how the stethoscope and the X-ray image are staged).

Diagnostic listening practices are still in use because they are cost-efficient, minimally invasive, free of adverse effects, genuinely mobile, and still a reliable source of medical knowledge. Or, as British physician Sir James Kingston Fowler puts it in his 1921 book on Pulmonary Tuberculosis:

Those who advise that all stethoscopes should be ‘scrapped’ may be influenced by the fact that they do not know how to use their own. ... A stethoscope is easier to carry than a cardiograph or X-ray installation ... Neither are common in the ‘bushstations’ of West Africa. (quoted after Bishop 1980: 456)

The Telephone as an Auditory Display in Experimental Physiology

I chose to recall practices of medical listening because they also point to yet another field of research in which acoustemic technologies emerged in the nineteenth century: the science of experimental physiology. In this section I will reconstruct a specific acoustemic technology which emerged in experimental physiology, namely electrophysiology, shortly after the invention of the electric telephone by Alexander Graham Bell in 1876. Physiologists used the telephone not only to study acoustic phenomena, such as spoken language or musical tones, but also “misused” the device creatively by connecting the telephone to dissected animal tissue. In doing so, physiologists were able to render bioelectric currents audible in order to investigate the activity of muscles and nerves. As Florian Dombois argues, these experiments may be regarded to be the historical origins of the so-called audification method (Dombois 2008: 42)—in sonification research, audification is defined as the direct conversion of signals or datastreams into sound (Kramer 1994: xxvii; Sterne and Akiyama 2012: 549–550).

Therefore, it seems worthwhile to trace the history of the telephone as a scientific instrument in electrophysiology in greater detail. Unlike the medical practices of percussion and mediate auscultation, however, the electric telephone was used within a relatively limited period of time and ​​research area. Nevertheless, this literally “electro-acoustic” use of the device as an acoustic display for bioelectric currents raises some interesting questions: What made electrophysiologists choose to convert electric currents into audible events and not, for instance, into visual or graphical representations? How may we assess the fact that the telephone was picked up by physiologists as a laboratory device almost immediately after its invention? And ultimately, why did telephonic observation fail to gain recognition similar to that of diagnostic listening practices in medicine?

Sounding Out the Nervous System

Neurophysiologists, and especially the so-called electrophysiologists who studied the electric activity of the nervous system, found themselves in a situation quite similar to that of the pioneers of pathological anatomy. Around 1850, it was difficult to detect the weak bioelectrical phenomena in muscles and nerves, and there were no ways of “looking” at them. Since electricity itself is neither visible nor audible, one of the major challenges in electrophysiology consisted of developing the proper design of experimental settings and display technologies in order to produce observable and stable scientific facts (Lenoir 1986).

Among the common “instrument” used in electrophysiological experiments at the time was the so-called frog galvanoscope, a vivisected frog leg with a nerve laid bare that was able to reveal the presence of weak currents of electricity by twitching when in contact with such currents. For this purpose, the end of the nerve was usually placed onto another muscle under observation. Since physiologists were trained physicians, most of them were quite familiar with acoustemic approaches. Not surprisingly, the stethoscope was used in electrophysiology as well, e.g. for tracing the movements of muscle contractions. When Alexander Graham Bell demonstrated his electrical telephone to the public in 1876, neurophysiologists soon recognized the potential of the device to serve as an electro-acoustic laboratory device.

Figure 4: Frog-leg galvanoscope (Du Bois-Reymond, 1860).

As early as December 1877 one of the pioneers in electrophysiological research, the German physiologist Emil Heinrich Du Bois-Reymond (1818–1896), demonstrated a number of experiments involving the telephone. Whereas most of these experiments were related to the study of the human voice and other acoustic phenomena, Du Bois also presented an electro-physiological setup. By connecting the telephone to a frog-leg galvanoscope, he managed to excite the frog leg by speaking into the telephone, thereby creating a rather bizarre animistic situation:

It is easy to achieve a twitch by the current of the telephone. [...] Evidently, the nerve seems to be more sensitive to some sounds than to others. If one calls out to him: ‘Jerk!’ the limb will jerk; on the first ‘i’ in ‘lie still’ it does not react. The sounds with deeper characteristic overtones are thus more effective than those with higher ones. (Du Bois-Reymond 1877: 576)

While Du Bois-Reymond had only used the telephone to produce currents in muscles, his students Julius Bernstein (1839–1917) and Ludimar Hermann (1838–1914) undertook various experiments in which they deployed the telephone as an auditory display.

Figure 5: Bell telephone of 1876, used both as mouthpiece and earphone.

In 1878 Hermann compared the sensitivity of the frog galvanoscope to that of the telephone to detect and display weak electrical currents that were conducted through the muscle tissue. One of Hermann’s motivations was the possibility of gaining new information about the muscle current that could not be attained otherwise. Unfortunately, his first results were negative because, as it turned out, the Bell telephone he had used was unable to make any of the weak currents audible (Hermann 1878). In the same year, the Russian physiologist Ivan Tarchanov (1846–1908) conducted a series of experiments in which he displayed various sounds of electric currents he had induced in muscles. The title of Tarchanov’s paper, The Telephone as a Display for Nerve and Muscle Currents in Man and Animal (Tarchanow 1878), clearly indicates that a “display” does not necessarily need to provide a visual output. Three years later, Bernstein and his assistant conducted a series of experiments with telephones built by the German manufacturer Siemens & Halske. The new devices were much more sensitive than the original Bell telephones and enabled Bernstein to render audible the natural electric currents present in animal muscles. Bernstein reported, for instance, that while the muscle of a dissected frog produced “a considerable rattle” sound while stimulating it with a train of electrical pulses, a tetanus in a rabbit’s leg caused “a deep singing tone in the telephone” (Bernstein and Schönlein 1881: 19, 22).

As these brief examples show, the production of resilient positive facts was a troublesome enterprise in electro-physiological research and depended heavily on state of the art technology. After Bernstein’s successful auditory observations, the telephone gradually became what the French historian of science Gaston Bachelard has come to call a “phenomentechnology”: a technological practice capable of generating artificial facts on which scientific reasoning is based (Bachelard 1970: 11–24). Shortly after Bernstein’s publication, other physiologists achieved the reproduction of his results in their own laboratories and conducted new experiments using telephonic observation. Throughout the 1880s the telephone became a common scientific instrument in the electrophysiological laboratory. Both the repertoire of sounds and the vocabulary that was used to describe them became successively more sophisticated. The Russian physiologist Nicolai Wedensky, for instance, distinguished physiological “muscle tones” from sounds caused by the experimental setup (Wedenskii 1883: 315). By varying his setup, Wedensky also described a number of new “telephonic phenomena” (Wedenskii 1883: 325). Among the sounds produced were not only various “muscle currents”, but also “nerve currents” (electric currents moving through the nerves) which were even weaker electric phenomena. By discussing sounds previously established in publications as well as by introducing new bioelectric sounds, a growing scientific discourse based on telephonic sounds as electrophysiological facts evolved. These enterprises lead to a form of physiological argumentation and reasoning based on sonic facts.

However, physiologists never undertook a systematic investigation of bioelectrical sounds similar to Auenbrugger’s and Laënnec’s exploration of bodily sounds. The telephonic method was primarily used to decide very specific sets of research questions. While the physicians had been able to link some of the perceived sounds to physical lesions using autopsy findings, the physiologists studying the nervous system could only speculate about the biochemical nature of the acoustic phenomena they produced.

Auditory vs. Visual Display

Around 1890 new developments led to major changes in the economy of display devices in the lab. While telephonic observation offered valuable clues to the general nature of the bioelectrical currents (by interpreting the pitch, the length, the quality, or the variation of the tones), the method could not give any information about the electrical oscillations in detail. Therefore Hermann, Bernstein, and others put a lot of effort into the design of devices for visually recording and displaying the weak electrical currents they were dealing with. Since the telephone was still a very sensitive electrometer, it was still used as a transducer. In order to work with the optical apparatus, the diaphragm of the telephone was turned into a reflective surface. When a bioelectric current set the membrane into motion, it not only produced a sound but also diffracted a beam of light, which was cast onto a revolving drum holding photographic paper as a recording surface.

According to Hermann, his main motivation to construct such a device had been “a growing desire for the graphic recording of the procedures” in his experiments (Hermann 1891: 539). Experiments relying on these hybrid opto-acoustical display technologies were initially called “phonophotographic studies” by Hermann and “phototelephonic studies” by Bernstein (Hermann 1889; Bernstein 1890; see also Sanderson 1890). The British physiologist John Burdon-Sanderson (1828–1905) was among the rigorous promoters of photographic observations:

The whole result is obtained by one observation, which is completed in a fraction of a second, and consequently all its details relate to one and the same process, not to a succession of processes differing more or less from the normal type. Granted that we are possessed of a canon of interpretation on which we can implicitly rely, the photographic curve has the inestimable advantage that it yields at once the information which the physiologist requires in such form as he requires it. (Sanderson 1895: 124–125)

Within a few years, a number of similar technologies were presented, resulting in a proliferation of myographically derived curves and photograms of electric oscillations in journals of physiology in the 1890s. Electrophysiological reasoning also shifted to discussing the visual shapes which were present in the graphical recordings of the action currents, such as bumps, spikes etc.:

The contrast between the electrical response in the uninjured gastrocnemius with that which is observed in the same muscle when injured by heat at its lower end is also perfectly well shown in these earlier records (Plate I. Fig. 3). No one can fail to see that the former, the ›spike,‹ is followed by what in similar language might be described as a ›hump,‹ and that if the former is taken to mean a sudden electrical swing of such a character as to indicate that the proximal electrode becomes first negative, then positive, the latter must indicate that it is followed by a change in the same direction but of slower progress. (Sanderson 1895: 135)

Due to this growing visual culture in electrophysiology, the telephone sounds rapidly lost their significance as epistemological facts. Despite this changing economy of display devices in the lab, however, the telephone was not entirely replaced by visual means. In 1900, the Russian researcher Nicolai Wedensky (1852–1922) still defended “the telephonic method” as “virtually irreplaceable” (Wedensky 1900: 139). According to Wedensky, only the telephone provided the unique possibility of quickly comparing action currents in different locations of the muscle or nerve under observation. He writes:

In the study of every complex process in the nerve fiber it is necessary to use the muscle, the telephone, and the galvanometer. Every one of these devices is speaking in its own language and appears to be a good witness under certain conditions and a weak one under others. (Wedensky 1900: 189)

As this statement shows, physiologists did not seem to care much about the actual sensual modality of the data they were producing and dealing with in the course of their experiments. What counted for them was that the phenomena could be used as facts on which they could base scientific arguments. In the electrophysiological lab of the late nineteenth century, the telephone became a multi-functional scientific instrument to render audible the bioelectric currents that were hidden to the eye of the observer. Furthermore, the telephone as an auditory display allowed the experimenter to verify whether or not electrical instruments worked, to determine the appropriate place for attaching the electrodes, and to identify errors in the experimental setup.

Acoustemic Technologies in the Early Twentieth Century

After the First World War, the dissemination of tube-based amplifiers lead to further improvements of graphical recordings in the life sciences. But even under these circumstances, scientists did not completely turn away from listening. In 1919, the German physiologist Rudolf Höber (1873–1953) repeated the sonic mapping of electrical activity in muscles and nerves with the help of a tube amplifier and a telephone. First, Höber tried to reproduce the experiments and sounds described by Bernstein and Wedensky some thirty years earlier. He also listened to the rhythms of contractions in patients suffering from certain diseases that affected their muscular or nervous activity, and produced graphic recordings of the corresponding currents. Höber concluded that these recordings were “largely concordant” with the facts he had already established through listening (Höber 1919: 310). In addition, Höber suggested an innovative sonic pedagogy. He proposed to amplify body sounds like the heartbeat for teaching purposes and suggested the use of similar technologies for teaching medical auscultation and other techniques of scientific listening to larger groups of students.

Figure 8: The “electrostethoscope,” consisting of microphone, amplifier, and gramophone horn as a speaker (Scheminzky 1927).

The Austrian physiologist Ferdinand Scheminzky (1899–1973) seized upon Höber’s suggestion and constructed an apparatus called “electrostethoscope” in the mid‑1920s. Scheminsky’s device consisted of an amplifier and several telephones designed to investigate bodily sounds. Like Höber, Scheminzky used the amplified signals to produce graphical recordings, to auscultate the human body, and to study bioelectrical phenomena (Scheminzky 1927: 499). By offering the opportunity to perform both mediate auscultation and bioelectrical audification, the electrostethoscope eventually incorporated two major practices of scientific listening of the nineteenth century into a single technology.

Conclusion: Notes on the Auditory Construction of Knowledge

By reconstructing case studies from the history of medicine and the life sciences, I assessed some questions regarding sonic ways of producing, representing, and constructing scientific knowledge. Sonic practices such as percussion, mediate auscultation, and the telephonic method in electrophysiology clearly show that acoustemic practices and technologies contributed to the production of scientific knowledge.

Both medical practices of the trained ear and the use of the telephone as an auditory display in electrophysiology were developed because the objects of study, be it diseases of the chest or the functionality of the nervous system, could not be represented adequately to meet the needs of the observer. From these case studies we may therefore conclude that acoustemic practices favorably emerge in response to in-visibilities, i.e. situations in which a direct visual observation or representation of the object of study is hindered or entirely impossible. This is not as trivial as it may seem. In the current discourse on sonification and auditory display, the use of sonification practices is often argued for by highlighting general advantages of hearing over seeing, such as the assumed greater temporal resolution of the ear compared to the eye. While, of course, facts like these are surely true, they may be totally irrelevant in the actual course of research processes. Auenbrugger and Laënnec favored the auditory channel not because they thought the ear to be a sense organ superior to the eye, but because only listening was capable of receiving sensual information from within the human body. Therefore we should refrain from comparing the faculty of vision to the sense of hearing in general, but rather take the unique and local circumstances of scientific research processes into account. The examples also showed that knowledge does not come by listening alone. If Laënnec had relied exclusively on listening to his patients, he would not have been able to trace the causalities between bodily sounds and the physical lesions that were hidden deep inside the body. Laënnec was only able to develop mediate auscultation into a reliable and convincing diagnostic practice because he could validate and stabilize these relations of sounds and lesions by performing thousands of autopsies.

Sonification researchers frequently blame an assumed “predominance” of the visual sense in Western culture and science to be the reason why scientists tend to be reluctant to integrate sonification technologies into their research environments (see, for example, Dayé and de Campo 2006: 350–352). From the case studies we need to conclude that the success of acoustemic practices is threatened less by a dominance of the eye but rather by incompatibilities with prevalent constructions of knowledge. While Auenbrugger’s percussion was neglected for half a century, the general success and dissemination of diagnostic listening practices in the nineteenth century was largely due to the fact that disease patterns had been re-constructed on the basis of sonic signs. On the other hand, electrophysiological arguments based on telephonic sounds were successively replaced by arguments based on photographic curves because the sounds were not able to yield information about the movements of single oscillations. Therefore sonification researchers should pay more attention to how a sonic form of epistemic practices, facts, and arguments may contribute to specific research processes instead of holding a general “ocular centrism” responsible for the sparse interest in the ear as an epistemic sense. This claim is further supported by the fact that diagnostic listening techniques were indeed considered to produce objective scientific results—as opposed to what the audio-visual litany suggests. This belief was not even impaired by the fact that these practices actually depended on the physician’s subjective sensory perception. Percussion and mediate auscultation were regarded as being objective because they were based upon sound physical facts, which originated at the site of the disease, undiluted by the subjective symptoms of sickness as articulated by the patient. Therefore, the practices of the trained ear were also an important aspect of the professionalization of the medical practice in the nineteenth century (Lachmund 1999; Sterne 2003: 136). It was only after the invention of X-ray photography that listening was problematized as a “subjective” activity.

The use of telephones in late nineteenth-century electrophysiology also hints to the productive power of the ambiguous notion of the sounding body. In an emerging world of technologies for sound reproduction and transmission, “sounding bodies” did not have to produce audible sound waves anymore, since all sorts of vibrating objects or other sources of oscillations could be audified, i.e. transduced into virtual sounding bodies. In this way, the electric telephone as an auditory display transformed muscles and nerves into sound sources allowing for electrical auscultations. Thereby, electrophysiological reasoning—at least in the 1880s—came to be based on sounds deliberately produced by this early form of audification. It should be evident that the mere technological possibility of performing such “synaesthetic conversions” (Mody 2012) is not a guarantee for scientific success. While physicians were able to refine their findings through autopsies, experimental physiologists lacked a comparable opportunity of verifying their assumptions on the nature of the audified bioelectrical currents. All they could do was to deduce muscle functions by the telephonic sounds, and later, by photographic recordings.

However, scientists will continue to welcome contemporary and future acoustemic technologies, provided that they do not merely convert data into a sonic form, but that they are capable of producing sonic facts for sound arguments.

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Axel Volmar, PhD (Dr. des.), is a teaching fellow in the Department of Media Studies at Siegen University, Germany. He is also a member of the international research network “Auditory Knowledge in Transition” (Hör-Wissen im Wandel) founded by the German Research Foundation. In his dissertation, Sound Experiments, he has studied the auditory culture of science since 1800 (forthcoming 2014). He has co-edited collected volumes on auditory media cultures (Auditive Medienkulturen. Techniken des Hörens und Praktiken der Klanggestaltung, with Jens Schröter, Bielefeld 2013) and the cultural history of data sonification (Das geschulte Ohr. Eine Kulturgeschichte der Sonifikation, with Andi Schoon, Bielefeld 2012). Forthcoming this August: “Listening to the Cold War: The Nuclear Test Ban Negotiations, Seismology, and Psychoacoustics 1958–1963,” Osiris 28 (2013). More information is available on his website.